European Journal of Ageing

, Volume 15, Issue 1, pp 57–65 | Cite as

Cognitive functioning is more closely related to real-life mobility than to laboratory-based mobility parameters

  • Eleftheria GiannouliEmail author
  • Otmar Bock
  • Wiebren Zijlstra
Original Investigation


Increasing evidence indicates that mobility depends on cognitive resources, but the exact relationships between various cognitive functions and different mobility parameters still need to be investigated. This study examines the hypothesis that cognitive functioning is more closely related to real-life mobility performance than to mobility capacity as measured with standardized laboratory tests. The final sample used for analysis consisted of 66 older adults (72.3 ± 5.6 years). Cognition was assessed by measures of planning (HOTAP test), spatial working memory (Grid-Span test) and visuospatial attention (Attention Window test). Mobility capacity was assessed by an instrumented version of the Timed Up-and-Go test (iTUG). Mobility performance was assessed with smartphones which collected accelerometer and GPS data over one week to determine the spatial extent and temporal duration of real-life activities. Data analyses involved an exploratory factor analysis and correlation analyses. Mobility measures were reduced to four orthogonal factors: the factor ‘real-life mobility’ correlated significantly with most cognitive measures (between r = .229 and r = .396); factors representing ‘sit-to-stand transition’ and ‘turn’ correlated with fewer cognitive measures (between r = .271 and r = .315 and between r = .210 and r = .316, respectively), and the factor representing straight gait correlated with only one cognitive measure (r = .237). Among the cognitive functions tested, visuospatial attention was associated with most mobility measures, executive functions with fewer and spatial working memory with only one mobility measure. Capacity and real-life performance represent different aspects of mobility. Real-life mobility is more closely associated with cognition than mobility capacity, and in our data this association is most pronounced for visuospatial attention. The close link between real-life mobility and visuospatial attention should be considered by interventions targeting mobility in old age.


Out-of-home mobility Ageing Life-space Instrumented Timed Up-and-Go test Capacity Performance 



We would like to gratefully acknowledge the assistance of Sandra Arenz, Sandra Brück, Henning Voss and Julia Wobst in data collection and Sabato Mellone in data processing and data analysis.


This study was funded by a grant from the German Sport University to the Graduate College ‘Reduced Mobility in Old Age’ and by the European Commission (FARSEEING, Seventh Framework Program, Cooperation—ICT, Grant Agreement No. 288940).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. Beurskens R, Bock O (2012) Age-related deficits of dual-task walking: a review. Neural Plast. doi: 10.1155/2012/131608 Google Scholar
  2. Ble A, Volpato S, Zuliani G, Guralnik JM, Bandinelli S, Lauretani F, Bartali B, Maraldi C, Fellin R, Ferrucci L (2005) Executive function correlates with walking speed in older persons: the InCHIANTI study. J Am Geriatr Soc 53:410–415CrossRefGoogle Scholar
  3. Buchman AS, Wilson RS, Bennett DA (2008) Total daily activity is associated with cognition in older persons. Am J Geriatr Psychiatry 16(8):697–701. doi: 10.1097/JGP.0b013e31817945f6 CrossRefGoogle Scholar
  4. Buchman AS, Boyle PA, Leurgans SE, Barnes LL, Bennett DA (2011) Cognitive function is associated with the development of mobility impairments in community-dwelling elders. Am J Geriatr Psychiatry 19(6):571–580. doi: 10.1097/JGP.0b013e3181ef7a2e.Cognitive CrossRefGoogle Scholar
  5. Carlson MC, Fried LP, Xue Q-L, Bandeen-Roche K, Zeger SL, Brandt J (1999) Association between executive attention and physical functional performance in community-dwelling older women. J Gerontol Ser B Psychol Sci Soc Sci 54B(5):S262–S270. doi: 10.1093/geronb/54B.5.S262 CrossRefGoogle Scholar
  6. Chaytor N, Schmitter-Edgecombe M (2003) The ecological validity of neuropsychological tests: a review of the literature on everyday cognitive skills. Neuropsychol Rev 13(4):181–197. doi: 10.1023/B:NERV.0000009483.91468.fb CrossRefGoogle Scholar
  7. Cohen RG, Vasavada AN, Wiest MM, Schmitter-Edgecombe M (2016) Mobility and upright posture are associated with different aspects of cognition in older adults. Front Aging Neurosci 8:257. doi: 10.3389/fnagi.2016.00257 CrossRefGoogle Scholar
  8. Costello A, Osborne J (2005) Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assess Res Eval 10(7)Google Scholar
  9. Crowe M, Andel R, Wadley VG, Okonkwo OC, Sawyer P, Allman RM (2008) Life-space and cognitive decline in a community-based sample of African American and Caucasian older adults. J Gerontol Ser A Biol Sci Med Sci 63(11):1241–1245. doi: 10.1093/gerona/63.11.1241 CrossRefGoogle Scholar
  10. Donoghue OA, Horgan NF, Savva GM, Cronin H, O’Regan C, Kenny RA (2012) Association between Timed Up-and-Go and memory, executive function, and processing speed. J Am Geriatr Soc 60(9):1681–1686. doi: 10.1111/j.1532-5415.2012.04120.x CrossRefGoogle Scholar
  11. Giannouli E, Bock O, Mellone S, Zijlstra W (2016) Mobility in old age: capacity is not performance. Biomed Res Int. doi: 10.1155/2016/3261567 Google Scholar
  12. Hale S, Myerson J, Rhee SH, Weiss CS, Abrams RA (1996) Selective interference with the maintenance of location information in working memory. Neuropsychology 10(2):228–240CrossRefGoogle Scholar
  13. Henson RK (2006) Use of exploratory factor analysis in published research: common errors and some comment on improved practice. Educ Psychol Meas 66(3):393–416. doi: 10.1177/0013164405282485 CrossRefGoogle Scholar
  14. Herman T, Giladi N, Hausdorff JM (2011) Properties of the “Timed Up and Go” test: more than meets the eye. Gerontology 57(3):203–210. doi: 10.1159/000314963 CrossRefGoogle Scholar
  15. Herman T, Weiss A, Brozgol M, Giladi N, Hausdorff JM (2014) Identifying axial and cognitive correlates in patients with Parkinson’s disease motor subtype using the instrumented Timed Up and Go. Exp Brain Res 232:713–721. doi: 10.1007/s00221-013-3778-8 CrossRefGoogle Scholar
  16. Holtzer R, Verghese J, Xue X, Lipton R (2006) Cognitive processes related to gait velocity: results from the Einstein aging study. Neuropsychology 20(2):215–223. doi: 10.1037/0894-4105.20.2.215 CrossRefGoogle Scholar
  17. Hüttermann S, Memmert D, Simons DJ, Bock O (2013) Fixation strategy influences the ability to focus attention on two spatially separate objects. PLoS ONE 8(6):6–13. doi: 10.1371/journal.pone.0065673 CrossRefGoogle Scholar
  18. Inzitari M, Newman A, Yaffe K (2007) Gait speed predicts decline in attention and psychomotor speed in older adults: the health aging and body composition study. Neuroepidemiology 29:156–162. doi: 10.1159/000111577 CrossRefGoogle Scholar
  19. Li KZH, Roudaia E, Lussier M, Bherer L, Leroux A, McKinley PA (2010) Benefits of cognitive dual-task training on balance performance in healthy older adults. J Gerontol Ser A Biol Sci Med Sci 65A(12):1344–1352. doi: 10.1093/gerona/glq151 CrossRefGoogle Scholar
  20. Martin KL, Blizzard L, Wood AG, Srikanth V, Thomson R, Sanders LM, Callisaya ML (2013) Cognitive function, gait, and gait variability in older people: a population-based study. J Gerontol Ser A Biol Sci Med Sci 68(6):726–732. doi: 10.1093/gerona/gls224 CrossRefGoogle Scholar
  21. McGough EL, Kelly VE, Logsdon RG, McCurry SM, Cochrane BB, Engel JM, Teri L (2011) Associations between physical performance and executive function in older adults with mild cognitive impairment: gait speed and the Timed “Up and Go” test. Phys Ther 91:1198–1207. doi: 10.2522/ptj.20100372 CrossRefGoogle Scholar
  22. Menant JC, Sturnieks DL, Brodie MAD, Smith ST, Lord SR, Woollacott M, Hermann F et al (2014) Visuospatial tasks affect locomotor control more than nonspatial tasks in older people. PLoS ONE 9(10):e109802. doi: 10.1371/journal.pone.0109802 CrossRefGoogle Scholar
  23. Menzel-Begemann A (2009) HOTAP – Handlungsorganisation und Tagesplanung. Testverfahren zur Erfassung der Planungsfähigkeit im Alltag, GöttingenGoogle Scholar
  24. Mielke MM, Roberts RO, Savica R, Cha R, Drubach DI, Christianson T, Petersen RC et al (2013) Assessing the temporal relationship between cognition and gait: slow gait predicts cognitive decline in the mayo clinic study of aging. J Gerontol Ser A Biol Sci Med Sci 68(8):929–937. doi: 10.1093/gerona/gls256 CrossRefGoogle Scholar
  25. Mirelman A, Weiss A, Buchman AS, Bennett DA, Giladi N, Hausdorff JM (2014) Association between performance on Timed Up and Go subtasks and mild cognitive impairment: further insights into the links between cognitive and motor function. J Am Geriatr Soc 62(4):673–678. doi: 10.1111/jgs.12734 CrossRefGoogle Scholar
  26. Owsley C, McGwin G (2004) Association between visual attention and mobility in older adults. J Am Geriatr Soc 52(11):1901–1906. doi: 10.1111/j.1532-5415.2004.52516.x CrossRefGoogle Scholar
  27. Podsiadlo D, Richardson S (1991) The Timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39(2):142–148. doi: 10.1111/j.1532-5415.1991.tb01616.x CrossRefGoogle Scholar
  28. Ryu U, Ahn K, Kim E, Kim M, Kim B, Woo S, Chang Y (2013) Adaptive step detection algorithm for wireless smart step counter. In: 2013 international conference on information science and applications (ICISA). IEEE, pp 1–4.
  29. Salarian A, Horak F (2010) iTUG, a sensitive and reliable measure of mobility. IEEE Trans Biomed Eng 18(3):1–18. doi: 10.1109/TNSRE.2010.2047606.iTUG Google Scholar
  30. Salarian A, Russmann H, Vingerhoets FJG, Dehollain C, Blanc Y, Burkhard PR, Aminian K (2004) Gait assessment in Parkinson’s disease: toward an ambulatory system for long-term monitoring. IEEE Trans Biomed Eng 51(8):1434–1443. doi: 10.1109/TBME.2004.827933 CrossRefGoogle Scholar
  31. Salarian A, Russmann H, Vingerhoets FJG, Burkhard PR, Aminian K (2007) Ambulatory monitoring of physical activities in patients with Parkinson’s disease. IEEE Trans Biomed Eng 54(12):2296–2299. doi: 10.1109/TBME.2007.896591 CrossRefGoogle Scholar
  32. Salarian A, Horak FB, Zampieri C, Carlson-Kuhta P, Nutt JG, Aminian K (2010) iTUG, a sensitive and reliable measure of mobility. IEEE Trans Neural Syst Rehabil Eng 18(3):303–310. doi: 10.1109/TNSRE.2010.2047606 CrossRefGoogle Scholar
  33. Sartori AC, Wadley VG, Clay OJ, Parisi JM, Crowe M (2012) The relationship between cognitive function and life-space: the potential role of personal control beliefs. Psychol Aging 27(2):364–374. doi: 10.1037/a0025212.The CrossRefGoogle Scholar
  34. Sasaki JE, John D, Freedson PS (2011) Validation and comparison of ActiGraph activity monitors. J Sci Med Sport 14(5):411–416. doi: 10.1016/j.jsams.2011.04.003 CrossRefGoogle Scholar
  35. Soumaré A, Tavernier B, Alpérovitch A, Tzourio C, Elbaz A (2009) A cross-sectional and longitudinal study of the relationship between walking speed and cognitive function in community-dwelling elderly people. J Gerontol Ser A Biol Sci Med Sci 64(10):1058–1065. doi: 10.1093/gerona/glp077 CrossRefGoogle Scholar
  36. Telonio A, Blanchet S, Maganaris CN, Baltzopoulos V, Villeneuve S, McFadyen BJ (2014) The division of visual attention affects the transition point from level walking to stair descent in healthy, active older adults. Exp Gerontol 50(1):26–33. doi: 10.1016/j.exger.2013.11.007 CrossRefGoogle Scholar
  37. Tung JY, Rose RV, Gammada E, Lam I, Roy EA, Black SE, Poupart P (2014) Measuring life space in older adults with mild-to-moderate Alzheimer’s disease using mobile phone GPS. Gerontology 60(2):154–162. doi: 10.1159/000355669 CrossRefGoogle Scholar
  38. van Lummel RC, Walgaard S, Pijnappels M, Elders PJM, Garcia-Aymerich J, van Dieën JH, Beek PJ (2015) Physical performance and physical activity in older adults: associated but separate domains of physical function in old age. PLoS ONE 10(12):e0144048. doi: 10.1371/journal.pone.0144048 CrossRefGoogle Scholar
  39. Wahl H, Wettstein M, Shoval N, Oswald F, Kaspar R, Issacson M, Heinik J et al (2013) Interplay of cognitive and motivational resources for out-of-home behavior in a sample of cognitively heterogeneous older adults: findings of the SenTra project. J Gerontol B Psychol Sci Soc Sci 68(5):691–702. doi: 10.1093/geronb/gbs106 CrossRefGoogle Scholar
  40. Webber S (2010) Mobility in older adults: a comprehensive framework. Gerontologist 50(4):443–450. doi: 10.1093/geront/gnq013 CrossRefGoogle Scholar
  41. Wettstein M, Wahl H-W, Shoval N, Auslander G, Oswald F, Heinik J (2014a) Cognitive status moderates the relationship between out-of-home behavior (OOHB), environmental mastery and affect. Arch Gerontol Geriatr 59(1):113–121. doi: 10.1016/j.archger.2014.03.015 CrossRefGoogle Scholar
  42. Wettstein M, Wahl H, Diehl MK (2014b) A multidimensional view of out-of-home behaviors in cognitively unimpaired older adults: examining differential effects of related predictors. Eur J Ageing 11:1–13CrossRefGoogle Scholar
  43. Williams B, Brown T, Onsman A (2012) Exploratory factor analysis: a five-step guide for novices. Aust J Paramed. Retrieved from
  44. World Health Organization (2005) International classification of functioning, disability, and health.
  45. Yogev-Seligmann G, Hausdorff JM, Giladi N (2008) The role of executive function and attention in gait. Mov Disord 23(3):329–342. doi: 10.1002/mds.21720 CrossRefGoogle Scholar
  46. Zhu W, Howard VJ, Wadley VG, Hutto B, Blair SN, Vena JE, Hooker SP et al (2015) Association between objectively measured physical activity and cognitive function in older adults-the reasons for geographic and racial differences in stroke study. J Am Geriatr Soc 63(12):2447–2454. doi: 10.1111/jgs.13829 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Eleftheria Giannouli
    • 1
    Email author
  • Otmar Bock
    • 2
  • Wiebren Zijlstra
    • 1
  1. 1.Institute of Movement and Sport GerontologyGerman Sport University CologneCologneGermany
  2. 2.Institute of Physiology and AnatomyGerman Sport University CologneCologneGermany

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